Efficiency drive hits brick wall

After more than a year of exploring ways to get more patients through Palmerston North Hospital’s operating theatres, a working group called ‘‘Optimise’’ can do no more.

Ear, nose and throat surgeon Paul Joice chaired the group trying to find ways to ensure existing theatre capacity was being used as efficiently as possible.

Despite improvements in how theatre lists and staffing were managed, he said staff could not change the fact they did not have enough.

‘‘The role of the board is to advocate for Midcentral Health. You need to put this back to where the money comes from.’’

Joice said the working group was set up in March 2017 because the heads of every surgical specialty were worried about the service they were providing.

‘‘We did not believe we had enough capacity in this hospital to do the job.’’

Although a new clinical services and theatre block would be the long-term solution, or extra theatres in the mid-term, group members determined to work together to make better use of what they had.

People had given a great deal of goodwill and time to attend meetings and carry out extra work to find solutions.

‘‘You need to put this back to where the money comes from.’’

He said better communication from surgeons helped.

All-day operating lists worked better than half-day sessions to provide flexibility to slot in acute surgeries such as caesarean sections for women in labour.

Having the same theatre teams of staff familiar with particular surgeons and the procedures they did and the equipment they needed helped.

So did having a clinical staff member to field questions often asked of booking clerks, which they were not qualified to answer.

Joice said while there were some gains that helped operations run more smoothly, there was ultimately no progress in freeing up extra theatre capacity.

The project was also undermined by the absence of useful data.

An external problem with the introduction of a new IT system had ‘‘absolutely kiboshed’’ the development of an effective theatre dashboard to track what was going on.

The board ended the last financial year with a $9.8 million deficit and was behind on its targets for carrying out elective surgery.